1) Personalized Medicine Decision Making in a Virtual Clinical Setting: This study enrolled Family Nurse Practitioner (FNP) students in two Programs at Samuel Merritt University on two different campuses. The study assessed the efficacy of two different strategies for integrating pharmacogenomics into the FNP curriculum. Outcomes will inform optimal strategies for integrating pharmacogenomics into the curriculum for nurses with prescriptive privileges. Campus 1 students received the intervention consisting of standard phamacogenomic curricular content, supplemental classroom education and a pharmacogenomic online case study. Campus 2 students served as controls, receiving standard pharmacogenomic curricular content. All students received an evaluation at the conclusion of their FNP curriculum consisting of an encounter with a virtual patient through an immersive virtual clinical environment (VCE). VCE users are immersed in an artificially-created environment so they perceive themselves to be interacting with the avatar. VCE provides experimental control and standardization of patient verbal/non-verbal content. Participants were randomized to a VCE Black or White patient to assess implicit bias. The study has completed enrollment and outcome assessments in 179 students. Data is now being analyzed. 2) Omics Nursing Science and Education Network (ONSEN): This was a multi-institute collaboration between NCI, NHGRI, and NINR. ONSEN is a website designed to facilitate achieving the recommendations of the Genomic Nursing Science Blueprint which prioritizes genomic nursing research topics. The ONSEN goal is to facilitate collaborations, mentoring, and access to training opportunities as a means to advance Omics nursing research and education. ONSEN has three sections: Education and Training provides information on mentoring, pre/postdoctoral opportunities, and a knowledge matrix to advance education and skills in genomic nursing science; Research Collaborations provides access to investigators conducting Omics nursing research who are interested in collaborations, sharing of samples and/or data; and Common Data Elements (CDE) provides information on the CDE benefits and links to CDE resources. ONSEN content was developed by experts in genomics, Omics, education, practice, and nursing research. Alpha testing to evaluate website content and functionality was conducted with workgroup members followed by beta testing with 83 end users on the test website. A soft launch occurred in August 2018 https://omicsnursingnetwork.net/ OMB Clearance was obtained to conduct an outcome assessment survey targeting users who have posted forms on the website. The survey will be distributed at the time of form annual renewals which will commence in August, 2019. A publication describing the website development is in final revisions. The publication will accompany an expanded ONSEN publicity campaign by NINR. 3) Global Genomics Nursing Alliance (G2NA): G2NA was established in 2017 led by the US, UK, and 23 global nursing leaders who attended a retreat funded by Wellcome Genome Campus Advanced Courses and Scientific Conferences (ACSC), Health Education England, and the Intramural Research Programs of the NCI and NHGRI. G2NA maintains a website https://g2na.org/ with funding and support from the University of South Wales; sustains quarterly education webinars; grown the countries represented; established a strategic plan; communicates through a listserv; completed or are conducting research projects described below; and secured funding from Wellcome Genome Campus ACSC for a global meeting on genomic implementation in nursing education and practice April 27-29, 2020. Five research projects have or are being conducted by G2NA: 1. A preliminary Genomic Global Nursing Landscape assessed nursing leaders and organizations using a purposive sampling strategy to assess the scope of genomic integration in practice and education, challenges and barriers, and priorities for action; 2. A resource assessment was conducted to identify existing global genomic resources, source, type and accessibility and resource gaps; 3. Establish and pilot test the MM, an outcome based tool to evaluate genomic capacity. Indicator measures are grouped into stages of maturity, creating a matrix of cells against an ordinal scale from new to established. The MM initial development used an iterative process with the G2NA constituency. It was then refined, pilot tested, and undergone further refinement; 4. Establish a Genomic Integration Roadmap for nursing. Roadmaps have been used in healthcare planning to provide a framework for achieving a desired outcome, in this case nursing genomic literacy and capacity. The Roadmap builds upon the MM to guide users with pathways forward that then can be measured using the MM. Manuscripts are completed for both the MM and Roadmap; and 5. Establish a Global Genomic Nursing Science Blueprint which builds on the US Genomic Nursing Science Blueprint which formed the basis for Omics Nursing Science and Education Network. Research is an essential underpinning to any implementation effort. This project starts with a systematic evidence review . A doctoral student under our supervision from the University of South Wales will perform the review work. 4) Genetic and Genomic Nursing Competency Update: The Genetic/Genomic Nursing Competency Initiative (GGNCI), established in 2004, oversaw the development and publication of The Essentials of Genetic and Genomic Nursing: Competencies (American Nurses Association, 2005). These competencies establish the minimum basis by which to prepare the nursing workforce to deliver competent genetic-and genomic-focused nursing care. The competencies were developed as a guide for nurse educators to help them in the design and implementation of educational programs that will support students and practicing nurses to achieve the genetic and genomic competencies. A Second Edition in 2009 included Outcome Indicators consisting of competency specific knowledge and clinical performance indicators. Now more than 10 years old, advances in genomic technology and evidence based clinical applications continue to impact nursing practice. Yet competency integration into practice and education remains uneven throughout the US and globally. Given the explosion of genomic healthcare applications, competencies that are current, valid, and achievable is critical to assuring the current and future nursing workforce has adequate capacity to integrate genomics into their practice. An Advisory Board was compiled to establish the optimal methods to update and revise the competencies. The resulting study is occurring in three phases. Phase 1 established a review panel consisting of individuals from academics, clinical education, clinical practice, ethics and policy, informatics, nursing leadership, organizational leadership, and regulation. Phase 2 consists of a Delphi survey completed by the review panel. Round one is currently in process and closes August 15, 2019. Phase 3 consists of the review panels review of 3 clinical cases to identify whether any competencies are missing or inadequate to address knowledge, skills or attitudes required of a nurse. The updated competencies will be published and posted on the American Nurses Association website to replace the posting of the existing competencies.